| Ammar Pllc | |
|
2863 Saint Rose Pkwy Henderson NV 89052-4806 | |
| (702) 790-1521 | |
| (702) 946-1439 |
| Full Name | Ammar Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2863 Saint Rose Pkwy, Henderson, Nevada |
| Authorized Official Name and Position | Tamer Ammar (PRESIDENT/OWNER) |
| Authorized Official Contact | 7027901521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ammar Pllc 2863 Saint Rose Pkwy Henderson NV 89052-4806 Ph: (702) 790-1521 | Ammar Pllc 2863 Saint Rose Pkwy Henderson NV 89052-4806 Ph: (702) 790-1521 |
| NPI Number | 1205375565 |
|---|---|
| Provider Enumeration Date | 02/20/2017 |
| Last Update Date | 01/03/2024 |
| Certification Date | 01/03/2024 |
| Medicare PECOS PAC ID | 6204107840 |
|---|---|
| Medicare Enrollment ID | O20170801000896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205375565 | NPI | - | NPPES |
| 14044 | Other | NV | NEVADA MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 14044 (Nevada) | Secondary |
| 2084V0102X | Psychiatry & Neurology - Vascular Neurology | 14044 (Nevada) | Primary |
| Provider Name | Tamer Ammar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780846303 PECOS PAC ID: 1456507425 Enrollment ID: I20120807000239 |
| Provider Name | Mara Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689227100 PECOS PAC ID: 1850623919 Enrollment ID: I20200421000570 |
| Provider Name | Supriya Kairamkonda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770038069 PECOS PAC ID: 6800213786 Enrollment ID: I20230905001784 |
| Provider Name | Keyvan Heshmati |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750840526 PECOS PAC ID: 7911440086 Enrollment ID: I20240617003692 |
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